Um, what are my muscles doing? How can I get them to stop?
April 11, 2013 8:09 PM   Subscribe

YANMD, but can you anecdotally solve/treat my medical mystery?

This is a follow-up to a question I asked last September (no need to read it).

Here's a (very) brief intro: last August, after a stressful summer, I randomly woke up with jaw pain. A few days and a migraine later, I saw the dentist who said "probably TMJ" and set me on a course of steroids. Jaw inflammation went away, headaches continued daily for several weeks--basically a month of One Straight Headache. After that, in September, I developed constant shoulder and upper back tension/pain. Headaches continued, weekly but sporadically (4 days a week, maybe?), throughout the autumn and winter. Then, around the time I went on a nice tropical vacation in January (coincidence?), the weekly tension headaches/occasional migraines almost completely ceased and were replaced by these tender patches on the back of my head; these are what I have had, maybe 4/5 days a week since. These vacillate between something I can barely sense to warm/nearly throbbing... spots? They feel very superficial, like it's on the skin, but when bad, they make me feel a little dizzy/disoriented/anxious. If they're bad, and I rub/massage them, I feel MUCH worse, slightly nauseated, dizzier, ugh. At the recommendation of my doc, I saw a neurologist who said these were "allodynia" and likely caused by semi-frequent untreated migraines. He gave me a migraine medication, I took it last night, and admittedly, haven't had these spots today.

Apart from the jaw, head, neck, shoulders, and upper back:

--Since mid-February, stomach tension that lasts anywhere from 3-5 days, then goes away for anywhere from a day to a week or more.
--Tightness in my chest. This was particularly bad, almost daily, a few weeks ago. Now it's less common. It occasionally wakes me up at night, or I wake up at night and notice it's bad.
--Most recently (over the past week), an odd sensation (pain?) in one or both knees and elbows. This goes away completely, then returns. Seemingly at random. Maybe both knees, maybe just one, maybe a knee and an elbow. The best way I can think to describe it is if you accidentally bumped your elbow and waited half an hour or so, so there's just a weird "something happened to my elbow recently" feeling. A sore sensation.

I have banished myself from Googling after obsessively fearing everything from brain tumors to stomach cancer.

Some important factors:
--The tension/pain is daily, but in some migrating constellation of muscles. It might change during the day. I might start with chest/stomach tension and end with just knees/elbow tension. But since September, it has never fully gone away--only changed shape. I haven't really ever had all symptoms at once. It's like Pain is a thing, in my body, traveling around.
--It is not debilitating or even awful. It is distracting, annoying, and uncomfortable. I can ignore it sometimes but not for long.
--I do not experience clumsiness or muscle weakness (I ran a few miles recently, did a bunch of push-ups, walk a mile to work most days and walk five flights up the stairs without feeling winded).
--I had a complete physical recently, everything came in as normal except for apparently, a surprise UTI.
--Things I've tried: semi-frequent warm baths, hot compress. I regularly sleep 8 hours a night. I have quite a lot of free time and am not overexerted.

The closest thing I've found in my own research is fibromyalgia, but for what it's worth, I don't really have fatigue, depression, or problems falling asleep. I do have mild anxiety (particularly about my HEALTH, IRONICALLY), though much less than last summer.

However, after this going on for 8 months without increasing dramatically in severity, I am willing to accept that it may be some kind of psychosomatic/anxiety weirdness expressing itself. Especially as I notice increased anxiety/panic intensifies the symptoms/pain. Here's the thing though: the pain is still real, and I still want it to go away.

Have you experienced any of these or similar symptoms? If so, what was it, and how did you address it? What helped, if anything? Did it eventually go away, and if so, in response to what?

(Thank you in advance for slogging through this question.)
posted by aintthattheway to Health & Fitness (13 answers total) 6 users marked this as a favorite
 
How's your stress level?
posted by bq at 8:25 PM on April 11, 2013 [2 favorites]


I am not a doctor. I am just guessing. Your nervous system got out of whack and hasn't totally recovered. Does that sound possible?
posted by icanbreathe at 8:46 PM on April 11, 2013


If stress is a trigger, make sure you're being kind to yourself: eating clean, avoiding caffeine/sugar/alcohol, daily stretching, a multivitamin/multimineral, an extra B-complex and an omega-3 supplement always helped me with nerve support. Getting checked for gluten intolerance, lactose intolerance and undiagnosed allergies couldn't hurt, either.

Have you tried meditation for anxiety? When I was going through a rough time, these free guided meditations helped me a lot. Good luck!
posted by doreur at 9:09 PM on April 11, 2013 [1 favorite]


Ok. Sounds like stress, but you're absolutely right, the pain is real and needs to stop. I suggest a three prong approach-

1.Therapy with a willingness to investigate the temporary use of anti-anxiety medications.

2.Meditation of some type. I find guided relaxation meditation tremendously helpful in times of stress. Commit to daily meditations at minimum.

3.Massage with a good massage therapist, one who specializes in relaxation or meditative massage. Maybe even try a Thai massage to increase your body awareness.

When I am acutely stressed I get wicked headaches and (what I'll politely call) productive nausea along with the overwhelming feeling that my body is failing me and is broken. Not true, of course, but the feeling is real. Taking the steps outlined above have helped me tremendously. I wish you wellness!!
posted by PorcineWithMe at 9:23 PM on April 11, 2013


I'd get checked out to see if you're grinding your teeth at night. Go to a jaw or facial pain clinic, not a dentist. I had a lot of the same symptoms and the root cause began in my jaw. The jaw tension affected my neck and the muscles in my skull (had pain/tenderness across my head) and would at times affect my shoulder/elbow. I'm not sure how it was all related, but on the same side that I had the jaw issues, I shoulder, hip, and foot pain.

I had symptoms on and off for years and wearing a jaw tray at night, and doing the jaw/neck self care, along with yoga and stress management has all but eliminated them for me.
posted by hannahelastic at 9:29 PM on April 11, 2013 [2 favorites]


My doctor told me muscle tension or pain can be due to low potassium. So eat some bananas or switch to Losalt as a potassium supplement; I don't suppose it can hurt.

For me, physical symptoms resolved a lot once I got a good loving-kindness meditation practice going, with the compassion directed at me. Start here.
posted by (F)utility at 9:35 PM on April 11, 2013


If you're male, cluster headaches are a possibility. You also probably have general muscle tension and trigger points, and fascial restriction/adhesions. Consider massage therapy from a competent, qualified and well-trained therapist. Also, drink more water.
posted by windykites at 9:41 PM on April 11, 2013


Also, the weird feelings could be caused by a nerve impingement or entrapment. Get checked out for spinal problems and do see a doc, the feelings do sound potentially like nerve feelings. It also sounds potentially like a lot of other things, including depression symptoms. What you are describing does not sound like it meets the criteria for fibromyalgia, but get a diagnosis. IANAD, TINADiagnosis, please see a doctor.
posted by windykites at 9:48 PM on April 11, 2013 [1 favorite]


Had this same thing exactly for over a year until a new doctor figured out that I was clenching my jaw at night, either from stress or as a side effect to medication. Old dr put me on all kinds of meds for migraine, had an MRI to rule out stroke, face eventually went numb, migraine with auras, the list goes on and on. After the old dr told me she thought I was just depressed and wanted to put me on yet another anti-depressant and painkiller, I walked out of that office and never went back.

New dr took me off all the meds, gave me a couple of cortisone shots in my neck and shoulder to relieve the inflammation there, sent me to the dentist to have my bite adjusted and a custom bite guard made, and walla, no more headache. Every now and then during times of stress, I will have to get the bite guard back out but usually only for a few days. I think I probably have a little bit of nerve damage to the nerve that runs along the top of my scalp because there is always a tender spot right on top. Dr said the jaw muscles were pulling on it when I was clenching. So long story short, the dentist can probably tell if you are grinding or clenching by the condition of your teeth and tongue. No matter what anybody says, the drugstore bite guards are not as good as the custom dentist made ones.
posted by tamitang at 9:59 PM on April 11, 2013 [3 favorites]


You may want to Google chiari malformation symptoms. My husband was recently diagnosed and he has some of what you describe.
posted by mama2clovy at 10:37 PM on April 11, 2013


Yes to jaw-clenching or teeth-grinding, but also the shoulder and head pain could all be some overly "clenched" shoulder muscles that are compressing cranial nerves. You might ask for a referral to a physical therapist -- I got a series of arm exercises that I go back to when things get tense again, and for the acute problem, I got my shoulders "taped," which is both theraputic and diagnostic: you can't hunch and clench, so you find out all the times when you were doing exactly those things (sitting badly at work, but also climbing stairs! etc.).

The whole ensemble sounds like a classic set of stress symptoms, so probably the long-term solution is going to involve changing something about your life (or possibly weathering it, if it's an acute thing like a job transition or a life crisis). Therapy maybe, and/or figuring out what you are reacting to so much in your daily life (especially something that happened/started about when all your symptoms appeared). You may already know.

Good luck! This stuff sucks, but it's part of learning to work better with our body machines.
posted by acm at 6:52 AM on April 12, 2013 [1 favorite]


I've had similar symptoms that were stress-related and to be honest I had to make a bunch of changes to my life to alleviate them. I'm still sort of an anxious person but making some targeted changes has dramatically changed my life for the better - in my case it involved relocating but your changes might not need to be that big.

For the TMJ be really mindful about not clenching your jaw. I used to clench and grind my teeth all the time and I think that clenching ends up expanding to other muscle groups as well. Periodically throughout the day, or if you realize you're clenching, actively unclench and do some jaw stretches/exercises. You know, the ones where you contort your face and look sort of ridiculous.

A friend of mine who has TMJ goes for regular massages, I think she has regular appointments at massage envy or one of those types of places and said that it has been a huge help to her. She said the massages are sometimes pretty painful but they actually produce results. Like one thing they do is hold up her head by a couple of pressure points behind the ears, and she said that it usually brings tears to her eyes but afterward she feels amazing.

For the stomach issues try ginger tea. If you're a ginger newbie start with bagged tea(I like Yogi brand) and then move on to making fresh ginger tea. The fresh ginger tea can be pretty potent but it is really amazing for stomach-related anxiety symptoms.
posted by fromageball at 6:59 AM on April 12, 2013 [1 favorite]


Speaking from personal experience, I know that I somaticize stress and anxiety in similar physical ways. I had a very painful TMJ episode before my wedding. This included headaches, earaches, and I was barely able to open my mouth wide enough to get a spoon in. I found that I was unconsciously clenching my jaw, which was one of several ways my body/brain decided to deal with the anxiety.

For the TMJ I saw an ENT and a Dentist. They both more or less shrugged. Basically, for whatever reason the muscles in your jaw and neck are a weird region that no one wants to treat. There are so few good outcomes from serious interventions (like surgery) that theres not much you can do past learning what triggers it, allow your self to fully heal from a flare up, and symptom treatment.

What I found worked for me was a steady dose of anti-inflamitories, and avoiding chewy foods during flare ups. A heating pad is nice too. Daily I try to stretch my neck, shoulders and arms (those things are all connected). I've also given up chewing gum (I used to buy those cups of 100 pieces), and for a long time I really missed it. I found that it was comforting somehow, which was all very unexpected to me.

I've also felt chest tightness, or feeling my heart pounding, especially at night which spirals into a worrying-about-feeling-it cycle which makes me feel it more.

I know you've accepted that this is all a possibility. You also know that this is real pain, you're not making it up, and you want relief from it. All I can offer is that fully coming to terms with this being somatized helps. Processing stressful events in more productive/active ways helps. That might be exercise, yoga, journaling, having long talks with friends/partners, taking to a therapist, and taking actions to get your un-acted upon desires/wants more in-line with what your actions are.

Taking advil/tylenol/over-the-counter stuff for the pain will help. It doesn't really matter how that pain is created, because its a real biochemical thing. Hot/cold therapy is another option. And I say this with lots of caveats, but alcohol in a responsible, moderate way can also help. (but not mixed with tylenol!) Obviously self-medication with alcohol to get through your daily-life is Bad Thing, but if every odd weekend you split a bottle of wine with a friend and talk and find some relief from stress, I'd consider that a Good Thing.

I've never been on any kind of anxiety medication or in therapy, but I know that should this all start really impacting my daily life, that is another recourse.

After the wedding a lot of those symptoms faded, but in retrospect I've had symptoms like that on-and off since being a teenager. (And could probably say my mom and sister have the same thing) For now, I try to be aware of it. I also know that when I'm experiencing those symptoms it's much more difficult to have that kind of perspective, and I think about what kind of weird rare neurological disease I have, or which doctors appointments I should schedule, (or how I should phrase my askme question about it...)
posted by fontophilic at 7:46 AM on April 12, 2013


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